| NPI | 1760477632 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 33472) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MT 157633) |
| Enumeration Date | 2005-09-15 |
| Last Update Date | 2024-04-02 |